Playtime In The Hospital Helps Allay Fears, Teach Children About

Illnesses

Helping To Make Hospital Stay Child's Play

In a room at Newington Children's Hospital, Christine Gardiner sits on the floor with a group of children. She holds Zachary, a rag doll wearing a T-shirt bearing the hospital's logo.

Gardiner uses a stethoscope to listen to Zachary's heart, then hands the stethoscope to 6-year-old Melissa Walczak, who will be entering the hospital for an eye operation. This will be Melissa's first time in the hospital, and Gardiner is there to help her understand what she will see and experience.

People like Gardiner were once known as "play ladies" who carted toys around to children in bed in the hospital. Now Gardiner is a "child-life therapist," a practitioner in a field that has grown into a clinical specialty. Therapists use a variety of techniques and play methods to help children cope with everything from minor surgery to serious chronic illness. Hartford Hospital, Manchester Memorial, New Britain General and St. Francis Hospital and Medical Center also have child-life programs.

An activity that seems to be child's play is preparing Melissa for her hospitalization. Her two brothers, Timothy, 8, and Chris, 11, are there too, because siblings also need to understand what is going on. Melissa takes the stethoscope from Gardiner and listens to her own heart. Her brother Timothy, wearing surgical gloves, pumps a blood pressure cuff on Zachary's arm, and watches the needle on the gauge spin. Out of a bag at Gardiner's side comes a small hospital gown for Zachary, elastic caps, an IV bag and anesthesia masks. The children put watermelon, cinnamon and bubble-gum-scented stickers into the masks and put the masks over their faces.

Derrick Swistak, 7, attaches the IV bag to Zachary's arm while Timothy holds it up and lets the solution drip down the tube. Derrick's sister Ashley, 3, will be entering the hospital for a spinal operation, and she watches the demonstration wide-eyed.

Later, the children walk through the operating area and recovery room with Gardiner and their parents. Gardiner shows the

children a row of brightly colored mechanical cars parked along one wall, which youngsters can use to drive themselves to the operating room when it's time for their operation.

"Play is important during hospital stays, whether the child will be hospitalized for a day or an extended stay," says Michele T. Confessore, director of Child Life programs at Newington and Hartford hospitals. "It's a stress reducer, a way to help children cope with their environment, and their illness." Zachary, for example, one of a pair of anatomically correct male and female dolls that have a removable kidney, appendix and other organs. Gardiner says children who have had surgery will get a chance do surgery on Zachary or give him a needle or IV. This helps children work through their feelings, gain mastery of the situation and clear up any misconceptions they may have.

Confessore says that children use all their senses to make a judgment about their environment, and the familiarity of play can help them adjust to a new situation. "One way to break the trance is to introduce play, which is the safest language for kids," she says.

The language of children is everywhere. Lacy white snowflakes hang like a paper snowfall in a hospital corridor. Photos of patients currently in the unit adorn one wall; watercolor pictures by young patients fill another. Colorful ceiling designs run the length of the corridor on the way to the operating room, where a child lying on a gurney would see them. A bright playroom crammed with stuffed animals, games and toys is more than just a place for kids to let off steam. Children know that once inside, they will not be stuck with needles or made to take medicine. A sign on the wall says, "Thank you for not doing any medical procedures in this room. The kids consider it a safe place." Down the hall, another room, which Confessore calls "the hangout," is for children age 11 and older. It is equipped with TV, VCR, Nintendo, stereo, books and games.

"We see a lot of the child's own experiences reflected back in play," Confessore says. "If the child has a head injury, the doll will have a head injury. If the child is going to have a leg operation because the bones won't grow, then the doll will have that operation."

And they have questions. "Kids don't always understand anesthesia. They say, `What do you mean a special kind of sleep? I wake up from a nap. Will I wake up in the middle of the operation?' " she says.

The concept of therapeutic play gives the child complete reign over the materials chosen and how they will be used. "What she's building right now," Confessore says, pointing to a little blond girl stacking colorful, interlocking building blocks, "could be a fort or could be a cage. It's what she needs it to be."

In years past, physicians and parents often thought it best to avoid giving children much information on their medical conditions, but the evolution of child-life as a specialty has significantly changed that point of view.